Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics > Oncology > Flashcards

Oncology Flashcards

1
Q

How common is cancer in children?

A 
Rare
< 1% of all cases of malignancy
Average GP will see 1 case in 15 years
Average DGH will see 5 cases a year
1 in 8000 develops cancer every year
1 in 600 develops cancer before age of 15
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How common is death in chilhood?

A

In 1st year of life - 580 deaths per 100,000
Age 1-4 27 deaths per 100,000
Age 5-14 12 deaths per 100,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the main causes of death in children?

A 
Injury
Cancer
CNS disorders
Respiratory disease
Congenital abnormalities
Infectious causes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How has survival of cancers improved?

A

Improved over the last 30 years

  • > 75% cured
  • 1 in 900 adults had cancer as a child
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What has the change in cancer survival done in terms of effects of treatment?

A

New problems - longer survival, new therapies

Life long follow-up essential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the differences between adult and childhood cancers?

A

Carcinomas are very rare in children
Embryonal tumours are rare in adults
Leukaemia occurs at all ages but more common in younger children
Bone tumours and lymphomas - peak incidence in early adolescence and early adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name 2 types of embryonal tumours

A

Wilms - kidney
Neuroblastoma
Rhabdomyosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes cancer in children?

A

Most cases unknown cause
- < 5% due to identifiable genetic abnormalities
- Double hit theory - interaction between environment and genetic susceptibility
Mutations in cellular genes
- Oncogenes, tumour suppressor genes, inherited eg retinoblastoma or sporadic
Some children at increased risk of cancer - Downs, immuno-compromised, NF1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How can cancers in children present?

A

Localised mass - lymphadenopathy, organomegaly, soft tissue or bony mass
Problems from disseminated disease - bone marrow infiltration
Problems from localised mass - airway obstruction from lymphadenopathy
Non-specific symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What could the diagnosis be in a child with recent UTI, pale and tired?

A

Post viral

Leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What could the diagnosis be in a child with lump in neck, otherwise well?

A

Atypical mycobacteria

Hodgkin’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What could the diagnosis be in a child with early morning headache?

A

Sinusitis

Brain tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What could the diagnosis be in a child with recurrent fever and bone pain?

A

Arthritis
Leukaemia
Ewing’s
Neuroblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What could the diagnosis be in a child with abnormal red reflex in eye?

A

Retinoblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What could the diagnosis be in a child with proptosis?

A

Infection
Neuroblastoma
Rhabdomyosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What could the diagnosis be in a child with recurrent discharging ear?

A

Infection
Rhabdomyosarcoma
LCH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When should you consider malignancy in children?

A

In any child whose condition doesn’t resolve or respond to treatment in the normal way

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common type of ALL?

A

B cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does ALL present?

A 
Fever
Fatigue
Frequent infection
Lymphadenopathy
Hepatomegaly and/or splenomegaly
Anaemia
Bruising/petechiae
Bone or joint pain
20
Q

What investigations should you do for ALL?

A 
Blood film
Serum chemistry
CXR
Bone marrow aspirate
LP
21
Q

What is the treatment for ALL?

A

Chemotherapy - 5 phases

Haemopoietic stem cell transplant

22
Q

What are the 5 stages of chemotherapy and how does it differ from boys to girls and why?

A 
Induction
Consolidation
Interim management
Delayed intensification
Maintenance
Boys treated for longer as higher risk of relapse
23
Q

When do you give haemopoietic stem cell transplants?

A

High risk patients in first remission

Relapsed patients

24
Q

How do CNS tumours present?

A 
Signs of raised ICP - headache often worse lying down, vomiting especially early morning, papilloedema
Squint
Nystagmus
Ataxia
Personality or behaviour change
25
Q

When should you scan a child with a headache?

A

If also papilloedema, decreased acuity or visual loss
If other neurological signs
If recurrent and/or early morning
If associated with vomiting - persistent, more frequent, preceded by headache
If also have short stature/decelerated linear growth
If age < 3
If have neurofibromatosis

26
Q

What are the different types of CNS tumours and what are their prognoses?

A

Pilocytic astrocytoma - low grade, best survival rate, high grade less so
Medulloblastoma 70%
Pontine glioma - palliative care
Neuroblastoma

27
Q

How are CNS tumours treated?

A

Surgery - resection, VP shunt
Chemotherapy - single agent/combination
Radiotherapy - for malignant tumours in older children, whole brain not used in very young

28
Q

How common is lymphadenopathy in children?

A

Up to 50%
Very common
Mostly due to self-limiting benign cause

29
Q

What can cause lymphadenopathy?

A

HIV
Autoimmune conditions
Storage disorders
Malignancy

30
Q

When should you biopsy lymphadenopathy?

A

Enlarging node without clear infective cause
Persistently enlarged node
Unusual site eg supraclavicular
Associated S&S
Fever, weight loss, enlarged spleen/liver
Abnormal CXR

31
Q

How is paediatric lymphoma treated?

A

Chemotherapy - determined by histology and stage
Radiotherapy - Hodgkin’s to residual bulk disease, NHL rarely
Surgery - mainly limited to biopsy
High dose therapy mainly for relapse
Survival relatively good for both types

32
Q

How might an abdominal tumour present?

A 
Mass only/with additional symptoms
Pain
Haematuria
Constipation
Hypertension
Weight loss
33
Q

What investigations should you do for an abdominal mass?

A

USS
CT scan
Biopsy

34
Q

What is the most common type of abdominal tumour in children?

A

Wilm’s

35
Q

How is a neuroblastoma treated?

A

Surgery - primary if resectable or following chemotherapy
Chemotherapy - type determined by stage and biology, high dose with HPSC high risk groups
Radiotherapy - mainly for high risk groups or at relapse

36
Q

What is a neuroblastoma?

A

Develops from neuroblasts left behind from babies development in womb so mainly affects babies and young children
Commonly occurs in one of the adrenal glands above kidneys or in nerve tissue next to spinal cord
Can spread to bone marrow, bone, lymph nodes, liver, and skin

37
Q

How common is neuroblastoma?

A

Affects around 100 children each year in UK

Most common in children under 5

38
Q

What are the possible symptoms for neuroblastoma?

A

Swollen, painful abdomen, constipation, difficulty urinating
SOB, dysphagia
Lump in neck
Blue tinged skin and bruising around eyes
Weakness in legs, unsteady walk, numbness in lower body
Fatigue, loss of energy, pale skin
Loss of appetite, weight loss
Bone pain, limp
General irritablity

39
Q

How is Wilm’s tumour treated?

A

Chemotherapy prior and following surgery
Nephrectomy/partial nephrectomy if bilateral
Radiotherapy if residual abdominal or pulmonary disease

40
Q

What is a retinoblastoma?

A

Eye cancer

41
Q

Who does retinoblastoma usually affect?

A

Children < 5

42
Q

What is the prognosis of retinoblastoma?

A

90% cured
Can affect one or both eyes
If both eyes - diagnosed before age of 1 usually
If one eye - diagnosed between 2 and 3

43
Q

What are the symptoms of retinoblastoma?

A 
Unusual white reflection in pupil
Squint
Change in colour of iris - in one eye or one area of eye
Red or inflamed eye
Poor vision
Loss of red reflex
44
Q

What can cause retinoblastoma?

A

Inherited - RB1 gene
Familial 40%
Sporadic

45
Q

How is retinoblastoma treated?

A

Multimodal therapy

46
Q

What are the late effects of treatment for cancer in children?

A 
Endocrine - growth and development issues
Intellectual
Cardiac toxicity
Renal toxicity
Fertility
Psychological

Paediatrics (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions